| NPI | 1760879092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S0291) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S0291) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AR E-13233) | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2022-10-12 |