| NPI | 1386204154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U3686) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10066724) |
| 207L00000X Anesthesiology (Licence: IA MD-55365) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2025-07-24 |