NPI | 1548245939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PR 12238) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 12238) |
Enumeration Date | 2005-12-08 |
Last Update Date | 2018-11-01 |