| NPI | 1164421053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: UT 361711-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NV 8751) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2013-01-23 |