| NPI | 1023578622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME MD29158) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U2854) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-06-03 |