| NPI | 1982137477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U3994) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD37396) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-10-16 |