| NPI | 1114283371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 8771575-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 8771575-1205) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2019-05-28 |