| NPI | 1295199834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T3881) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD048152) |
| Enumeration Date | 2016-04-10 |
| Last Update Date | 2023-07-20 |