| NPI | 1396737359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K6627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D45782) |
| 207L00000X Anesthesiology (Licence: MN 57798) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2022-09-22 |