| NPI | 1366932410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 48051) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301505209) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2023-08-30 |