| NPI | 1073141040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12439690-1205) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: UT 12439690-1205) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-06-11 |