| NPI | 1205062742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM A-2141-18) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N9004) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2018-06-25 |