| NPI | 1386649184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K1024) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 19873) |
| 207L00000X Anesthesiology (Licence: UT 11277275-1205) | |
| 207L00000X Anesthesiology (Licence: AZ 57844) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2021-08-04 |