| NPI | 1518301332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R6612) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD181028) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2023-09-29 |