| NPI | 1265752315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q9072) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R72157) |
| 207L00000X Anesthesiology (Licence: TX Q9072) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2025-09-17 |