| NPI | 1578826095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME156601) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S8579) |
| 207L00000X Anesthesiology (Licence: CA A142098) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2022-07-24 |