| NPI | 1558775445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T6612) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD465910) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX S6612) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-07-11 |