| NPI | 1215371125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 56420) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R3202) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R3202) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2018-09-04 |