| NPI | 1356455240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S8718) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 244544) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2024-04-24 |