| NPI | 1679568653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q7776) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 229309) |
| 207L00000X Anesthesiology (Licence: NJ 25MA11681700) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2024-04-09 |