| NPI | 1083689798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 20264) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 20264) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-07-23 |