| NPI | 1053420877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD25863) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TN MD25863) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2026-07-20 |