| NPI | 1013117886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61403352) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P1748) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2023-10-20 |