| NPI | 1649581109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P8904) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P8904) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 122742) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2026-03-23 |