NPI | 1215028204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 25879) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S3039) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2022-07-21 |