| NPI | 1730414327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2015-02026) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2015-02026) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2017-09-08 |