| NPI | 1740426055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2016-00995) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2016-00995) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2022-07-21 |