NPI | 1063679165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.21660) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 26985-020) |
Enumeration Date | 2008-05-18 |
Last Update Date | 2008-05-18 |