| NPI | 1518344571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S2502) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX XXXXXXXXXXXXXX) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2021-11-23 |