| NPI | 1740278084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 5876867-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID M8298) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2021-11-15 |