| NPI | 1275760803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 324193)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P6444)  | 
| 207L00000X Anesthesiology (Licence: NM MD2017-0763)  | |
| 208600000X Surgery (Licence: CO TL3345)  | |
| Enumeration Date | 2009-06-22 | 
| Last Update Date | 2024-07-08 |