| NPI | 1083656060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K6504) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD29600) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2025-08-01 |