| NPI | 1225458904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R7725) |
| Additional Taxonomies | 208VP0000X (Licence: TX R7725) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2023-01-27 |