| NPI | 1467958371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U7609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301508182) |
| 207L00000X Anesthesiology (Licence: NY 314772) | |
| 207L00000X Anesthesiology (Licence: IL 036.174113) | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2025-11-03 |