| NPI | 1346406568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME149512) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101247037) |
| 207L00000X Anesthesiology (Licence: TX Resident) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2023-04-14 |