| NPI | 1497066310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q4069) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.057964) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2021-01-13 |