| NPI | 1679910574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3389) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10047100) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2018-06-05 |