| NPI | 1669479374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101249468) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 197187) |
| 207L00000X Anesthesiology (Licence: MD D0062365) | |
| 207L00000X Anesthesiology (Licence: FL ME124285) | |
| 207L00000X Anesthesiology (Licence: PA MD428861) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2026-06-23 |