| NPI | 1235617549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MF211434) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10063164) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2022-10-03 |