NPI | 1790244804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V1567) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 13249347-1204) |
207L00000X Anesthesiology (Licence: IA DO-07073) | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2025-07-24 |