| NPI | 1326423948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3922) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2022-06-02 |