| NPI | 1902047087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R5291) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 251377) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2022-01-26 |