| NPI | 1366705063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD182007) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX U0651) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2025-12-29 |