| NPI | 1669883658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S1801) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP20058373) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2019-06-28 |