| NPI | 1417369471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10422353-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 58366) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-04-27 |