| NPI | 1275519985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N0454) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 32799) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2021-12-16 |