| NPI | 1255361838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G63429) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G63429) |
| 208VP0000X (Licence: CA G63429) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2025-06-03 |