| NPI | 1356803233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO3723) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U8444) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-12-02 |