| NPI | 1144663196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S1158) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 269536) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX S1158) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2022-06-13 |