| NPI | 1992143051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 332519) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 9408224) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 332519) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2023-05-01 |