| NPI | 1902010069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R8751) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007008378) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2025-06-11 |