| NPI | 1598796021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L9236) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L9236) |
| 207Q00000X Family Medicine (Licence: TX L9236) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-10-29 |