| NPI | 1124082250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T5325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 047596) |
| 207L00000X Anesthesiology (Licence: TX 41738) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-08-23 |