| NPI | 1134341787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0066965) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT183795) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2023-08-15 |