| NPI | 1194779736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 28333) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 28333) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2014-09-30 |