| NPI | 1184036998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S9675) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D84789) |
| 207R00000X Internal Medicine (Licence: FL TRN# 20256) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2024-03-25 |