| NPI | 1720041692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K4127) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 11399) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2017-03-20 |