| NPI | 1619020401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 10764) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 10764) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-08-26 |