| NPI | 1124221445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P7621) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM A-1606-11) |
| 207L00000X Anesthesiology (Licence: PA OT012239) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-09-08 |