| NPI | 1497079420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R0478) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME121483) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2018-06-11 |