| NPI | 1992099386 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q2974) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 28504) | 
| 207L00000X Anesthesiology (Licence: CO DR.0059908) | |
| Enumeration Date | 2011-06-03 | 
| Last Update Date | 2025-04-11 |