| NPI | 1578795514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C208677) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD450556) |
| 207L00000X Anesthesiology (Licence: NY 272460) | |
| Enumeration Date | 2009-08-09 |
| Last Update Date | 2026-07-09 |