| NPI | 1417124090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N0707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 233484) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2020-06-09 |