| NPI | 1831164011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 014053) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: IA 33745) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2018-08-29 |