| NPI | 1265729420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q4389) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2022-06-24 |