| NPI | 1194250993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D94745) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024031782) |
| 207L00000X Anesthesiology (Licence: DC MD049225) | |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2024-08-29 |