NPI | 1811330764 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX R3592) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 269573) |
207L00000X Anesthesiology (Licence: TX R3592) | |
207L00000X Anesthesiology (Licence: TX BP10046236) | |
Enumeration Date | 2013-04-10 |
Last Update Date | 2022-06-09 |