| NPI | 1316938038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 60395) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N3489) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 49423) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2018-09-18 |