| NPI | 1386131266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD211718) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10063368) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2022-08-06 |