| NPI | 1396002994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 52626) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q6612) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2019-11-23 |