| NPI | 1447576152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10950402-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.124558) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2015-01787) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2018-12-05 |