| NPI | 1235875006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX W2033) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2026-01590) |
| 207L00000X Anesthesiology (Licence: TX BP10079471) | |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2026-05-31 |