| NPI | 1134303712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q6648) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2012-00383) |
| 207L00000X Anesthesiology (Licence: MD D72689) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2022-10-04 |