| NPI | 1669783064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 49953) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 49953) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-05-09 |