| NPI | 1568638138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S8584) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD445703) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: PA MD445703) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: TX S8584) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2021-05-26 |