| NPI | 1750598520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 377750-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 80206) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-04-14 |