| NPI | 1154857597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2023017874) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 315699) |
| 207L00000X Anesthesiology (Licence: VA 010126583) | |
| 207L00000X Anesthesiology (Licence: OK 39555) | |
| 207L00000X Anesthesiology (Licence: TX T6719) | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2024-11-07 |