| NPI | 1689098550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R9824) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 28750) |
| 207L00000X Anesthesiology (Licence: NV 22212) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 28750) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 22212) | |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2024-06-07 |