| NPI | 1144404427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2008-00401) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2008-00401) |
| Enumeration Date | 2007-12-22 |
| Last Update Date | 2017-09-05 |