| NPI | 1346558632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P8395) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10037938) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2020-06-10 |