| NPI | 1093801151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 98-352896-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 22124) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-03-13 |