| NPI | 1730535105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S5359) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 79570) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2026-08-07 |