| NPI | 1558401679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T4900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A9234) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2022-07-25 |