| NPI | 1033555131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101269477) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD460296) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2026-06-25 |