| NPI | 1356549802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P5211) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 60223674) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2018-06-05 |