| NPI | 1417912726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A73147) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A73147) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-01-30 |