| NPI | 1376170258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 787850-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY TL8406) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2024-09-24 |