| NPI | 1245550888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A119125) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q0153) |
| Enumeration Date | 2010-06-05 |
| Last Update Date | 2026-03-17 |