| NPI | 1285013607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S6966) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX FT9355670) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2025-04-01 |