| NPI | 1790927671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2019-02595) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q4227) |
| 207L00000X Anesthesiology (Licence: VA 0101246915) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2022-06-07 |