| NPI | 1992849921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0065196) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2007-00123) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 200700123) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0065196) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2023-08-25 |