| NPI | 1093782096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N4486) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024028305) |
| 207L00000X Anesthesiology (Licence: PA MD426051) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2024-07-23 |