| NPI | 1629303490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX Q1689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194762) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2018-11-01 |