| NPI | 1114913373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 037477) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 037477) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2018-07-26 |