| NPI | 1598858136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 90-182959-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 20693) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-01-30 |