| NPI | 1386932259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T1635) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 7785) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX T1635) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2022-05-11 |