| NPI | 1134485295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD467026) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX MD467026) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2025-05-06 |