| NPI | 1760987762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD476882) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD476882) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-08-01 |