| NPI | 1588751614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M6853) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD36303) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-06-25 |