| NPI | 1164468930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L5075) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L5075) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-07-22 |