| NPI | 1669850665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO2788) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 7839219-1204) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-11-30 |