| NPI | 1447785712 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S9926) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A195404) | 
| Enumeration Date | 2017-04-25 | 
| Last Update Date | 2024-07-03 |