| NPI | 1851705594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10050297) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 27681) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2026-09-28 |