| NPI | 1073747150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A 112634) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N9850) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2011-12-20 |