| NPI | 1578940391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 34776) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 58069) |
| 207L00000X Anesthesiology (Licence: IA 50058) | |
| 207L00000X Anesthesiology (Licence: TX BP10054063) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2022-06-24 |