| NPI | 1174527964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L3719) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L3719) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX l3719) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2025-11-08 |