| NPI | 1972582310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M3331) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL me 93920) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2019-11-20 |