| NPI | 1285610170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 2202) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 582) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-09-16 |