| NPI | 1578580114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q5602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2003015186) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-10-25 |