| NPI | 1336109420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR0060456) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K1027) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-01-09 |