| NPI | 1780888362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M6782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0026969) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2025-08-14 |