| NPI | 1265677439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D82259) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD044416) |
| 207L00000X Anesthesiology (Licence: NY 2599551) | |
| 207L00000X Anesthesiology (Licence: VA 101260469) | |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2026-04-17 |