| NPI | 1568971463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME152289) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T9403) |
| 207L00000X Anesthesiology (Licence: IL 125071578) | |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2026-03-27 |