| NPI | 1508855875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K6999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-069990C) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2026-01-28 |