| NPI | 1548624521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A154246) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11725858-1205) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-06-10 |