| NPI | 1073709077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 20567) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: SC MD84680) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2024-03-14 |