| NPI | 1093336711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX W2133) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A163482) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2026-04-07 |