| NPI | 1568474849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD473986) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301103410) |
| 207L00000X Anesthesiology (Licence: AZ 35651) | |
| 207L00000X Anesthesiology (Licence: WI 70521) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2026-02-11 |