| NPI | 1629052931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-1347) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K9478) |
| 207L00000X Anesthesiology (Licence: AZ 36000) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2023-03-07 |