| NPI | 1154716413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R5766) | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX R5766) | 
| Enumeration Date | 2015-04-03 | 
| Last Update Date | 2024-05-20 |