| NPI | 1093209157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101276457) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD485454) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101276457) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2025-10-28 |