| NPI | 1508399809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 14188239-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 14188239-8905) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2026-04-14 |