| NPI | 1194951194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A99869) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 7318332-1205) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2026-07-21 |