| NPI | 1275705949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 22727) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MS 22727) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2022-12-15 |