| NPI | 1992099386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q2974) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 28504) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2015-11-11 |