| NPI | 1275512030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AR N7862) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR N7862) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2022-10-18 |