| NPI | 1225326838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R6838) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD451365) |
| 207R00000X Internal Medicine (Licence: PA MT199814) | |
| Enumeration Date | 2011-07-16 |
| Last Update Date | 2019-10-16 |