| NPI | 1356631162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2019-00430) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R1544) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2019-00430) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2019-07-03 |