| NPI | 1922153907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 6619) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA C37925) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 12694) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |