| NPI | 1063456614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 49847) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H7613) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-10-20 |