| NPI | 1629033576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q8782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK PENDING) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2022-06-22 |