| NPI | 1710547575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U4652) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10067085) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2026-01-13 |