| NPI | 1871795120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 5174-320) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N0956) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-01-07 |