| NPI | 1740285683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO R3L53) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-55073) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2025-09-16 |