| NPI | 1033538954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10049546) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI pending) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2019-07-10 |