| NPI | 1972732642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q0036) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX Q0036) |
| 207L00000X Anesthesiology (Licence: TX Q0036) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2020-08-18 |