| NPI | 1649776378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD70065355) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 315855) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2026-02-26 |