| NPI | 1225249915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P0131) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 51636-20) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2018-07-09 |