| NPI | 1851544258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 29675) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.29675) |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2024-02-01 |