| NPI | 1346211190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K5771) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9700175) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-03-30 |