| NPI | 1881788388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P0288) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101240502) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-07-21 |