| NPI | 1609196088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q3821) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10036784) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2016-07-28 |