| NPI | 1023052669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N7458) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX FTL 42151) |
| 207L00000X Anesthesiology (Licence: TX FTL 42574) | |
| 207L00000X Anesthesiology (Licence: MS 22415) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2025-07-29 |