| NPI | 1518900042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 6632553-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.201309) |
| 207P00000X Emergency Medicine (Licence: MS 19024) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2021-10-25 |