| NPI | 1760412688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX E9125) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 14717) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-04-26 |