| NPI | 1114072659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N0317) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2006012208) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2006012208) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-04-27 |