| NPI | 1629204722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S4948) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 135674) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2022-04-06 |