| NPI | 1518426329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP61525328) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U3661) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-07-24 |