| NPI | 1487658126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q1287) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM A-938-91) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2023-09-25 |