| NPI | 1225371586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX R5318) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R5318) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2021-08-25 |