| NPI | 1053485557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A65222) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A65222) |
| 207L00000X Anesthesiology (Licence: TX R1903) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-10-16 |