| NPI | 1093716854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: MD D0055905) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0055905) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0055905) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-09-27 |