| NPI | 1952388738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX J8850) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10489) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-07-11 |