| NPI | 1982979092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3127) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX R3127) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2017-10-09 |