| NPI | 1619312485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q8546) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10047307) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2020-10-07 |