| NPI | 1316467434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T0591) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-11028) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-02-10 |