| NPI | 1184202855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD491476) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 13222) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-09-13 |