| NPI | 1063706976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S6951) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102203364) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2022-06-07 |