| NPI | 1942610241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R5451) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 19256) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-01-27 |