| NPI | 1073855383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MI 4301103945) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301103945) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-12-29 |