| NPI | 1295965275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P2926) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT193001) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2018-06-28 |