| NPI | 1528252558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A100812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ PG#81647) |
| 207L00000X Anesthesiology (Licence: CA A100812) | |
| Enumeration Date | 2007-09-03 |
| Last Update Date | 2016-04-27 |