| NPI | 1144607656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13899496-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R74958) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2024-05-29 |