| NPI | 1992196026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S9175) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 1600) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S9175) | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2025-02-19 |