| NPI | 1487972436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T1777) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SD 9220) |
| 207L00000X Anesthesiology (Licence: MN 54523) | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2023-03-13 |