| NPI | 1063613727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V4228) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301097710) |
| 207L00000X Anesthesiology (Licence: NY 246928-1) | |
| 207L00000X Anesthesiology (Licence: VT 042.0013037) | |
| 207L00000X Anesthesiology (Licence: IN 01079496A) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2025-08-18 |