| NPI | 1265843387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10844373-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-66513) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2023-05-18 |