| NPI | 1386816965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME119664) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P2847) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2022-03-21 |