| NPI | 1437610623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 338174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 338174) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2023-10-06 |