| NPI | 1538420849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T9713) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2015-01939) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2023-03-10 |