| NPI | 1003903790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G36224) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G36224) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-08 |