| NPI | 1174910392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S5875) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S5875) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX S5875) | |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2024-11-25 |