| NPI | 1538289772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 7029) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SD 7029) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2017-12-07 |