| NPI | 1811200199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 83082) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P9703) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2021-03-04 |