| NPI | 1295786010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164621) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K7268) |
| 207L00000X Anesthesiology (Licence: IA MD-55357) | |
| 207L00000X Anesthesiology (Licence: NV 16781) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2026-05-13 |