| NPI | 1548642002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R1134) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX R1134) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2024-05-23 |