| NPI | 1932557691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S5942) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT211428) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2022-06-08 |