| NPI | 1528562287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 21941) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11405427-1205) |
| 207L00000X Anesthesiology (Licence: TX T4779) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2023-12-07 |