| NPI | 1154827293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 83298) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T0570) |
| 208D00000X General Practice (Licence: TX T0570) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-10-17 |