| NPI | 1629045943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX H4654) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C51921) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2020-08-25 |