| NPI | 1023545944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 307836) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10060896) |
| 207R00000X Internal Medicine (Licence: TX BP10060896) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2021-03-05 |