| NPI | 1376803338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D80709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02508) |
| 207L00000X Anesthesiology (Licence: FL TRN18403) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2026-07-22 |