| NPI | 1427266899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2008003498) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2004014124) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2018-03-27 |