| NPI | 1710997093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-55378) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO CDR.0004964) |
| 207L00000X Anesthesiology (Licence: PA MD428777) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY C5000) | |
| 207L00000X Anesthesiology (Licence: WI 4640-320) | |
| 207L00000X Anesthesiology (Licence: WA MD60057947) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2026-03-26 |