| NPI | 1013200518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q4103) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 5513) |
| 207L00000X Anesthesiology (Licence: TX BP20047389) | |
| 207L00000X Anesthesiology (Licence: OK 30968) | |
| 207R00000X Internal Medicine (Licence: TX BP1-0040910) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2019-03-18 |