| NPI | 1326037987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R2883) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD057919L) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2021-12-23 |