| NPI | 1427323765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY TP720) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX Q9869) |
| 207L00000X Anesthesiology (Licence: MS 32249) | |
| 207L00000X Anesthesiology (Licence: FL ME165900) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2025-11-06 |