| NPI | 1760869697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX S7161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S7161) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IL 36150091) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2020-09-03 |