| NPI | 1669850277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MT208602) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D0102497) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2026-02-23 |