| NPI | 1912943788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L3493) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L3493) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-07-29 |