| NPI | 1801129762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P9766) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 255279) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2020-05-20 |