| NPI | 1538348438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P4191) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.202164) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 57012824) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2024-02-07 |