| NPI | 1659862985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 323028) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10064949) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2023-10-12 |