| NPI | 1104919257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K6539) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 101661) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-10-17 |