| NPI | 1295966372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 8598448-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 13733-320) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2025-08-29 |