| NPI | 1083863690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A100695) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A100695) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2021-10-03 |