| NPI | 1316986581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 44534) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX R5985) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-08-16 |