| NPI | 1154557262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P4770) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT195544) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2018-07-31 |