| NPI | 1306131966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q8036) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 261976) |
| 207L00000X Anesthesiology (Licence: TX 557742) | |
| 208VP0000X (Licence: TX Q8036) | |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2018-10-19 |