| NPI | 1194928283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 28333) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N6721) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-11-19 |