| NPI | 1528160769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 4979083-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 115334) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2022-09-08 |