| NPI | 1275529976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 90171) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G8513) |
| 207L00000X Anesthesiology (Licence: GA 032679) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 200001633) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2008-05-06 |