| NPI | 1609875103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD0000027537) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD467834) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2026-03-24 |