| NPI | 1619238094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R2417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R73382) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2020-09-23 |