| NPI | 1942643606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S6086) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD464870) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2020-07-31 |