| NPI | 1205270840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3149) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10047310) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-07-25 |