| NPI | 1871810721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2014-02062) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2014-02062) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2023-08-14 |