| NPI | 1801848130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12118581-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID M9271) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-10-26 |