| NPI | 1346225521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N3777) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 219311) |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2020-06-30 |