| NPI | 1396773255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX W1556) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2006-0103) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2026-01-13 |