| NPI | 1265899843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101262941) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0099084) |
| 207L00000X Anesthesiology (Licence: DC MD600004097) | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2026-02-02 |