| NPI | 1710349139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S7345) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 267470) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2020-07-02 |