| NPI | 1154479269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N5353) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10024995) |
| 207L00000X Anesthesiology (Licence: MA 233095) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-09-23 |