NPI | 1164414793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX H2060) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H2060) |
Enumeration Date | 2005-08-19 |
Last Update Date | 2019-08-19 |