| NPI | 1801046669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR0058597)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX FTL 42831)  | 
| 207L00000X Anesthesiology (Licence: TX FTL 42422)  | |
| Enumeration Date | 2008-09-29 | 
| Last Update Date | 2024-05-07 |