| NPI | 1215676242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10079469) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 341909) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2026-07-07 |