| NPI | 1578186078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR DO219474) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10070507) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2024-08-21 |