| NPI | 1306285234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10135487-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN19056) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2018-02-27 |