| NPI | 1043281744 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 315335)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L2595)  | 
| Enumeration Date | 2006-01-30 | 
| Last Update Date | 2022-09-01 |