| NPI | 1487969655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 47446) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA TR60527531) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2022-01-20 |