| NPI | 1184925703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N7828) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N7828) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2021-08-23 |