| NPI | 1184152746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2022012747) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S3187) |
| 207L00000X Anesthesiology (Licence: MO 2022012747) | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2025-09-08 |