| NPI | 1881960987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 9363159-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 49280) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2018-02-27 |