| NPI | 1801892914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N5497) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 162823) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2024-06-24 |