| NPI | 1700029857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA MD41831) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-41831) | 
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL TRN#12555) | |
| Enumeration Date | 2009-04-18 | 
| Last Update Date | 2025-03-25 |