| NPI | 1184918781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 558244) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WY 10720A) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2024-04-01 |