| NPI | 1104111673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q3750) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q3750) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2025-02-24 |