| NPI | 1164878831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S6150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056517) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2020-07-24 |