| NPI | 1083695274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX W1313) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 59984) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2026-05-12 |