| NPI | 1538505409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 11390723-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME133061) |
| 207R00000X Internal Medicine (Licence: AZ R73780) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2024-11-19 |