| NPI | 1083818645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N1631) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0022049) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-05-10 |