| NPI | 1891770855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 12932) |
| Additional Taxonomies | 174400000X Specialist |
| 207L00000X Anesthesiology (Licence: AL 12932) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2021-02-25 |