| NPI | 1205051638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R2586) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 45678) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2022-09-23 |