| NPI | 1093165649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T0625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10056114) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-10-17 |