| NPI | 1679778625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD223212) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 7650601-1205) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2025-01-28 |