| NPI | 1326676214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V1647) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS22807) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-09-17 |