| NPI | 1558781583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R5026) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10049550) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2024-07-25 |