| NPI | 1750677167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CA 137054) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 137054) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2015-06-24 |