| NPI | 1811212293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N6684) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 256170-1) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2022-09-29 |