| NPI | 1497192702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 54777) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q5906) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2021-09-07 |