| NPI | 1790750339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX G5939) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 39926) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-11-10 |