| NPI | 1659591022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S3289) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101239920) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2019-11-07 |