| NPI | 1083753164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 57944) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 224984) |
| 207L00000X Anesthesiology (Licence: TX M9988) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2018-08-01 |