| NPI | 1609932664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX W2174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 043656) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2025-12-09 |