| NPI | 1952805236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T4576) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072698) |
| 207L00000X Anesthesiology (Licence: NC 251322) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2022-08-04 |