| NPI | 1417578709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2025-01804) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 13865872-1205) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2026-02-02 |