| NPI | 1780686535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX F4136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F4136) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2010-12-01 |