| NPI | 1407871973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI MD13069) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A90303) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A90303) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2014-07-01 |