| NPI | 1477589489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 55380) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K6304) |
| 207L00000X Anesthesiology (Licence: TX K6304) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-02-18 |