| NPI | 1730562513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 19899) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 19899) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2026-02-19 |