| NPI | 1275892713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 67879) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R0108) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX R0108) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2020-12-01 |