| NPI | 1093809758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 94-276424-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD222710) |
| 207L00000X Anesthesiology (Licence: ND 22105) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-04-24 |