| NPI | 1487604971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 22655) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 22655) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: NC 22655) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-04-13 |