| NPI | 1083031371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10736642-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR DO222757) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2025-01-15 |