| NPI | 1548201031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME74736) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-55120) |
| 207L00000X Anesthesiology (Licence: IL 036144995) | |
| 207L00000X Anesthesiology (Licence: KY C4589) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2025-11-11 |