| NPI | 1952503948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N7869) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL trn4472) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.201672) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2015-03-27 |