| NPI | 1629496369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T3102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 3208) |
| 207L00000X Anesthesiology (Licence: NE 31578) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2024-12-18 |