| NPI | 1841291804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C200307) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L9049) |
| 207L00000X Anesthesiology (Licence: NM 2003-0436) | |
| 207L00000X Anesthesiology (Licence: AZ 51249) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2026-01-15 |