| NPI | 1740378801 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K4347) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX K4347) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2011-08-05 |