| NPI | 1396234928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U4253) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102205932) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2025-05-22 |