| NPI | 1710389507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S1295) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024041564) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2024-10-21 |