| NPI | 1699731331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME MD27754) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 81177) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX R2623) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35-127617) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CT 81177) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35-127617) | |
| 207L00000X Anesthesiology (Licence: NY 257174) | |
| 207L00000X Anesthesiology (Licence: OH 35-127617) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2025-09-03 |