| NPI | 1316963150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T2136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 51353) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-11-08 |