| NPI | 1114971405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD459504) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D63001) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: MD D63001) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-05-08 |