| NPI | 1255569307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R-2894) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB09283800) |
| 207L00000X Anesthesiology (Licence: NY 2593931) | |
| Enumeration Date | 2009-06-28 |
| Last Update Date | 2026-06-02 |