| NPI | 1558984906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 105384) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10072227) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2025-10-06 |