| NPI | 1235422668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R5896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-42404) |
| 207L00000X Anesthesiology (Licence: IA R-9121) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2020-08-25 |