| NPI | 1235457839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P9957) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP-10037941) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2022-07-15 |