| NPI | 1407817984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2023-0636) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 11952) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2023-07-25 |