| NPI | 1912430927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101288144) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U5944) |
| 207L00000X Anesthesiology (Licence: AZ 66122) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2026-01-16 |