| NPI | 1306131982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 28696) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q5607) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2017-05-09 |