| NPI | 1558990176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 342005) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 342005) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2025-01-16 |