| NPI | 1922205848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 9169318-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A97208) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2021-11-12 |