| NPI | 1396989067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P6117) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P6117) |
| 207L00000X Anesthesiology (Licence: TX BP1-0034754) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2020-01-05 |