| NPI | 1649435090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M8913) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A103560) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX M8913) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2022-10-07 |