| NPI | 1184030777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V9745) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX V9745) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2025-10-09 |