| NPI | 1790244804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V1567) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 13249347-1204) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-02-20 |