| NPI | 1801390109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T6611) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T6611) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-03-10 |