| NPI | 1285053439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2021011171) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R7009) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-05-23 |