| NPI | 1508202029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3261) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 29833) |
| 207L00000X Anesthesiology (Licence: MA 272214) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2022-07-21 |