| NPI | 1386816379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P5326) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P5326) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME132163) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2025-09-28 |