| NPI | 1760773279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 92910) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A113918) |
| 207L00000X Anesthesiology (Licence: TX U5016) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2025-01-10 |