| NPI | 1669609178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 67076) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P8890) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2025-02-21 |