| NPI | 1497044200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S0158) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 140898) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2022-05-04 |