| NPI | 1720240039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 22672) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P0325) |
| 207L00000X Anesthesiology (Licence: GA 080660) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2019-03-29 |