| NPI | 1164849527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 11116700-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 11116700-1205) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2022-09-20 |