| NPI | 1164915344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13334773-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10063296) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2023-09-01 |