| NPI | 1538420914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S1056) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS018883) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2021-12-09 |