| NPI | 1972913002 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX Q7370) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q7370) | 
| Enumeration Date | 2014-04-29 | 
| Last Update Date | 2020-01-29 |