| NPI | 1972024107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T4834) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC DO035017) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2022-10-05 |