| NPI | 1871855163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q7849) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10043172) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2018-03-17 |