| NPI | 1437105608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD17117) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: TN MD17117) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2023-03-07 |