| NPI | 1942246566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 6049595-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR DO218658) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2024-04-12 |