| NPI | 1699749804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD16764) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD16764) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2009-11-24 |