| NPI | 1265859342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S5058) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60826947) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2020-05-06 |