| NPI | 1003071341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61682981) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 262870) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2025-10-22 |