| NPI | 1659305803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R7089) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G74302) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-09-23 |