| NPI | 1417319732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX U3449) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U3449) |
| 207L00000X Anesthesiology (Licence: NY 305291) | |
| 207L00000X Anesthesiology (Licence: IL 036152495) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-10-15 |