| NPI | 1427092592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: NM A-964-99) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM A-964-99) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-07-18 |