| NPI | 1487655353 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H0065941)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L8292)  | 
| 207L00000X Anesthesiology (Licence: MD MD21921)  | |
| Enumeration Date | 2005-08-02 | 
| Last Update Date | 2024-09-26 |