| NPI | 1104346568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 0000004702) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TN 0000004702) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2026-01-06 |