| NPI | 1164435533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T9951) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME91782) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2025-08-05 |