| NPI | 1013940212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T8104) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 101952) |
| 207L00000X Anesthesiology (Licence: PA MD428689) | |
| 207L00000X Anesthesiology (Licence: OH 35.145993) | |
| 207L00000X Anesthesiology (Licence: FL ME146198) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2025-08-27 |