| NPI | 1164401816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M0960) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX m0960) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2020-08-27 |