| NPI | 1013150481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 30401) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10033746) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2020-07-29 |