| NPI | 1285745158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G52161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD27419) |
| 207L00000X Anesthesiology (Licence: UT 82-169038-1205) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-09-19 |