| NPI | 1124235965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2008018534) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY C4859) |
| 207L00000X Anesthesiology (Licence: IA 36283) | |
| 207L00000X Anesthesiology (Licence: IL 036123483) | |
| 207L00000X Anesthesiology (Licence: NE 28235) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-12-08 |