| NPI | 1114595097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 14211590-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10076987) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2025-08-07 |