| NPI | 1225047749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WV 27850) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01053861A) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-07-21 |