| NPI | 1952729055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 19512) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MT207867) |
| 207L00000X Anesthesiology (Licence: PA MT207867) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2023-09-01 |