| NPI | 1871708008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 47946) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 39238) |
| 207L00000X Anesthesiology (Licence: IA SP187) | |
| 207L00000X Anesthesiology (Licence: MI 4301089013) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2024-05-14 |