| NPI | 1629020045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-11401) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 5416069-1205) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-04-08 |