NPI | 1992148720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101272514) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 85223) |
Enumeration Date | 2013-04-11 |
Last Update Date | 2025-03-13 |