| NPI | 1316434103 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 67220) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10063869) | 
| Enumeration Date | 2018-04-17 | 
| Last Update Date | 2022-10-03 |