| NPI | 1902390255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U0117) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10063867) |
| 207L00000X Anesthesiology (Licence: AR E-15723) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2024-01-30 |