| NPI | 1467565986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX H7496) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H7496) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2022-06-09 |