| NPI | 1487813879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 41545) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A99764) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A99764) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2023-03-07 |