| NPI | 1205497047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U8394) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 695477) | 
| Enumeration Date | 2019-06-24 | 
| Last Update Date | 2024-09-12 |