| NPI | 1710408869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T7704) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 009676) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2025-07-18 |