| NPI | 1487650305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 15070) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 101368) |
| 207L00000X Anesthesiology (Licence: OK 39260) | |
| 207L00000X Anesthesiology (Licence: TX E0861) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2025-05-02 |