| NPI | 1215973516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q7182) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D42057) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-04-27 |