| NPI | 1619534393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U6714) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 136115531205) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2024-11-06 |