| NPI | 1922083898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9500077) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 9500077) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-11-14 |