| NPI | 1033112933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.32468) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L5579) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2026-08-04 |