| NPI | 1336559418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX 60518) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 60518) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2020-03-10 |