| NPI | 1053303206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L6045) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 11390) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2020-10-09 |