| NPI | 1316053465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD042615) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101248339) |
| 207L00000X Anesthesiology (Licence: MD D0076752) | |
| 207L00000X Anesthesiology (Licence: PA MD436042) | |
| 207L00000X Anesthesiology (Licence: OH 35-083834) | |
| 207L00000X Anesthesiology (Licence: FL ME89641) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-10-22 |