| NPI | 1164487641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S4262) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 17245) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-12-10 |