| NPI | 1487393575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 14243428-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID MRM-2365) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2025-11-05 |