| NPI | 1639432107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q7443) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2012018813) |
| 207L00000X Anesthesiology (Licence: NH 19742) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2024-04-27 |