| NPI | 1619945839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L2144) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2003007037) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2003007037) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-11 |