| NPI | 1568624914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N5435) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP20027763) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-03-13 |