| NPI | 1104443910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V8706) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2020018146) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2025-10-15 |