| NPI | 1568666162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N4977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0026249) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-06-09 |