| NPI | 1750657755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2025-1115) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 18057) |
| 207L00000X Anesthesiology (Licence: CO DR0057098) | |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2025-11-03 |