| NPI | 1659759231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R7201) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10053743) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2020-02-12 |