| NPI | 1083724504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L8687) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L8687) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX L8687) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-04-22 |