| NPI | 1699271833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V8058) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 307896) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2025-08-07 |