| NPI | 1053433938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P6037) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: TX P6037) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-03-07 |