| NPI | 1841520277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 19948) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: UT 7264856-1202) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2020-07-02 |