| NPI | 1023403334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S4014) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A16613) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2020-07-28 |