| NPI | 1326199001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L5073) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2021006319) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2025-09-15 |