| NPI | 1083998736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q2055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT200614) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2022-08-16 |