| NPI | 1558447961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N8133) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND PT 11855) |
| 207L00000X Anesthesiology (Licence: WI 51755-20) | |
| 207L00000X Anesthesiology (Licence: ND 11855) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2023-08-25 |