| NPI | 1184884389 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P3224) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 26358) | 
| Enumeration Date | 2008-06-11 | 
| Last Update Date | 2022-10-07 |