| NPI | 1639531650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 67890-21) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 13703732-1204) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2024-01-25 |