| NPI | 1629310321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R9773) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 28105) |
| 207L00000X Anesthesiology (Licence: NM MD2018-0754) | |
| 207L00000X Anesthesiology (Licence: TN 63737) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2023-06-23 |