| NPI | 1659311769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q1673) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: TX Q1673) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-12-14 |