| NPI | 1205255478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T7482) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 321765) |
| 208600000X Surgery (Licence: TX BP10050311) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-04-30 |