| NPI | 1245302736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N5667) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024017762) |
| 207L00000X Anesthesiology (Licence: ME MD16476) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2025-08-26 |