| NPI | 1336302066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P4679) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 704) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-11-08 |