| NPI | 1265496079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P0529) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2005011146) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 96230) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2016-03-09 |