| NPI | 1114900040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 28021) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F6512) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2019-07-25 |