| NPI | 1205362076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T0367) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10060851) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-09-02 |