| NPI | 1437612660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13284635-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 13284635-1205) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2023-10-04 |