| NPI | 1316478191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 297260) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT MED-PHYS-COM-LIC-132) |
| 207L00000X Anesthesiology (Licence: WA MD61153830) | |
| 207L00000X Anesthesiology (Licence: TX T9277) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2024-12-26 |