| NPI | 1730573643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX U4273) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 303232) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 303232) | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2023-11-02 |