| NPI | 1821022906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12215280-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 00023724) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-07-09 |