| NPI | 1578908026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S3595) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: TX S3595) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2021-10-11 |