| NPI | 1689872228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q8997) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 45719) |
| 208600000X Surgery (Licence: MI 4301090893) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-07-24 |