| NPI | 1265721351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: OR MD170823) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD170823) |
| 207L00000X Anesthesiology (Licence: AZ 57347) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: OR MD170823) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2023-02-15 |