| NPI | 1508192022 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 298147) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 33027) | 
| 207L00000X Anesthesiology (Licence: CO 41000) | |
| 207L00000X Anesthesiology (Licence: GA 057266) | |
| 207L00000X Anesthesiology (Licence: FL ME85866) | |
| Enumeration Date | 2009-10-19 | 
| Last Update Date | 2024-11-25 |