| NPI | 1003955014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 7396839-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N4316) |
| 207L00000X Anesthesiology (Licence: NM 2005-0293) | |
| 207L00000X Anesthesiology (Licence: IN 01063474A) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2021-11-11 |