| NPI | 1962598177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M5993) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2006-0294) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2021-06-24 |