| NPI | 1861802100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R6251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10050364) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-06-02 |