| NPI | 1003966227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M11396) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD229174) |
| 207L00000X Anesthesiology (Licence: MT 11302) | |
| 207L00000X Anesthesiology (Licence: IA MD-54947) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2026-05-13 |