| NPI | 1508256470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD048894) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0090105) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2025-07-28 |