| NPI | 1144600073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD469916) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 278076) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2023-02-07 |