| NPI | 1710331079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 12269611-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS16799) |
| 208VP0000X (Licence: UT 12269611-1204) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2025-07-10 |