| NPI | 1134651565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12243254-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD222881) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-02-19 |