NPI | 1649581109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P8904) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 122742) |
Enumeration Date | 2010-06-29 |
Last Update Date | 2017-03-08 |