| NPI | 1023471539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T7949) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 67674) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2022-11-30 |