| NPI | 1013270875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60751696) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q8523) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-07-21 |