| NPI | 1639162712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX J4334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J4334) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J4334) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2025-09-11 |