| NPI | 1750483384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L9201) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L9201) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2018-09-15 |