| NPI | 1598907834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R7280) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME115793) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2022-07-08 |