| NPI | 1558449355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A76196) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S9275) |
| 207L00000X Anesthesiology (Licence: GA 89911) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-11-02 |