| NPI | 1336111392 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD33486) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D60523) | 
| Enumeration Date | 2006-02-03 | 
| Last Update Date | 2024-11-08 |