| NPI | 1689617631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S3624) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME95527) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-06-16 |