| NPI | 1881855567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P2963) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 12449773-1204) |
| 207L00000X Anesthesiology (Licence: OR DO176008) | |
| 207L00000X Anesthesiology (Licence: NE 739) | |
| 207L00000X Anesthesiology (Licence: MT 26113) | |
| 207L00000X Anesthesiology (Licence: CA 20A 12856) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2022-06-01 |