| NPI | 1407241342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 11327071-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 57324) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-03-18 |