| NPI | 1275984742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10057138) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY C5756) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2026-07-06 |