| NPI | 1922668532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1014363) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10066727) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-06-26 |