| NPI | 1114908456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L6968) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L6968) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2020-08-28 |