| NPI | 1629503115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 1959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T3189) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2024-03-14 |