| NPI | 1376651729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 22010) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 22010) |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2022-02-16 |