| NPI | 1184917585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX R0701) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10040672) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2022-07-21 |