| NPI | 1346624608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 20430) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 20430) |
| 207L00000X Anesthesiology (Licence: IL 125.067803) | |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2020-07-08 |