| NPI | 1679505440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U4048) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 22063) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2026-04-22 |