| NPI | 1396279923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T0059) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 32929) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2022-07-27 |