| NPI | 1629005707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101283197) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 227272) |
| 207L00000X Anesthesiology (Licence: TX M7507) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2024-11-05 |