| NPI | 1477895639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R7342) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 130995) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2019-10-08 |