| NPI | 1023502093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12751738-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2018020285) |
| 207L00000X Anesthesiology (Licence: MO 2020029411) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 12751738-1205) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2022-08-12 |