| NPI | 1225656184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 38069) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 38069) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2026-07-07 |