| NPI | 1831389063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q9695) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS015620) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS015620) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q9695) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2024-11-18 |