| NPI | 1063692028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 11950062-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N1976) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2021-10-25 |