| NPI | 1679705099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2009025406) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M8527) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2023-09-14 |