| NPI | 1518918317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 34558) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2011020441) |
| 207L00000X Anesthesiology (Licence: IA MD-34558) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036118396) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-09-23 |