| NPI | 1710204516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P8203) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP-1 0037942) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2022-09-09 |