| NPI | 1588862114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C192246) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101260667) |
| 207L00000X Anesthesiology (Licence: FL ME109122) | |
| 207L00000X Anesthesiology (Licence: TX U4391) | |
| 207L00000X Anesthesiology (Licence: WI 3049-320) | |
| 207L00000X Anesthesiology (Licence: OH 35.098567) | |
| 207L00000X Anesthesiology (Licence: MO 2024049040) | |
| 207L00000X Anesthesiology (Licence: IN 01076345A) | |
| 207L00000X Anesthesiology (Licence: IA R8025) | |
| 207L00000X Anesthesiology (Licence: OR MD217005) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2026-05-07 |