| NPI | 1407809817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX F3140) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX F3140) |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: TX F3140) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX F3140) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2014-03-20 |