| NPI | 1467422113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD486529) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 049765) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 049765) | |
| 207L00000X Anesthesiology (Licence: KY 43374) | |
| 207L00000X Anesthesiology (Licence: MO 2012004815) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2026-08-04 |