| NPI | 1710964903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDRH0033745) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R7038) |
| 207L00000X Anesthesiology (Licence: CO 33745) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-03-16 |