| NPI | 1861753709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AR E-10371) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2017004412) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-08-25 |