| NPI | 1063948800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T1942) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10060839) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-06-16 |