| NPI | 1104891142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX J3387) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J3387) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-10-04 |