| NPI | 1083933089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q2071) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 275245) |
| Enumeration Date | 2010-05-31 |
| Last Update Date | 2024-02-01 |