| NPI | 1114042579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3176) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 24229s) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2026-10-06 |