| NPI | 1801116850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R1706) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 52295) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2021-08-18 |