| NPI | 1992903173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12052769-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT191516) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2021-10-25 |