| NPI | 1295732923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN DO0000001935) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 3564) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 3564) | |
| 207L00000X Anesthesiology (Licence: IN 02003014A) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2012-02-01 |