| NPI | 1649775222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: UT 7599018-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 7599018-1205) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-09-26 |