| NPI | 1518945864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M5552) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 053196) |
| 207L00000X Anesthesiology (Licence: LA DO000014) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2018-05-14 |