| NPI | 1922569961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U2862) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 75280) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2024-10-30 |