| NPI | 1114918224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 14829) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 18045) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2026-08-05 |