| NPI | 1528233020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD445547) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301101675) |
| 207L00000X Anesthesiology (Licence: NY 264337) | |
| 207L00000X Anesthesiology (Licence: FL ME116627) | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2025-03-20 |