| NPI | 1871790451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.204772) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 204772) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 61260) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2024-01-01 |