| NPI | 1548653256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2025-0056) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2025-0056) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2025-01-24 |