| NPI | 1235589441 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-47005)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10659)  | 
| Enumeration Date | 2016-06-18 | 
| Last Update Date | 2024-06-26 |