| NPI | 1578026233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL OS22158) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS023159) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2026-03-04 |