| NPI | 1306801824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0054897) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D54897) |
| 207L00000X Anesthesiology (Licence: OR MD23614) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2026-03-09 |