| NPI | 1477725075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P1982) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R1940) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2020-09-08 |