| NPI | 1003105065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R3834) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 266112) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-02-28 |