| NPI | 1568738482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 101290) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R1352) |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2024-09-11 |