| NPI | 1447224415 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM A-2246-19) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L-9100) | 
| Enumeration Date | 2006-02-15 | 
| Last Update Date | 2019-05-23 |