| NPI | 1437595402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R1599) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10046232) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2021-07-12 |