| NPI | 1811558620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V0221) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2019022495) |
| 207L00000X Anesthesiology (Licence: MO 2019023485) | |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2024-08-16 |