| NPI | 1073627683 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R3016) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R3016) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX R3016) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-05-16 |