| NPI | 1396165536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 34888) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R5807) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2025-01-29 |