| NPI | 1346380508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M6702) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301084282) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2022-09-14 |