| NPI | 1255329322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L5924) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301503504) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2024-10-10 |