| NPI | 1467414243 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00047182) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-54219) | 
| Enumeration Date | 2006-04-05 | 
| Last Update Date | 2025-07-08 |