| NPI | 1366975963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D93959) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D93959) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0093959) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2023-04-14 |