| NPI | 1922369503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q2604) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX Q2604) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2024-09-04 |