| NPI | 1639246754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX K4883) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A52501) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2017-03-09 |