| NPI | 1902225139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A160637) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A160637) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A160637) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A160637) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2026-07-24 |