| NPI | 1568411106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD039737E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1024386) |
| 207L00000X Anesthesiology (Licence: ME MD13717) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-12-16 |