| NPI | 1811350200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 87918) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T9837) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2023-03-06 |