| NPI | 1619536612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U0631) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10067091) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2023-06-21 |