| NPI | 1831509488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD203560) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 9529018-1205) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2025-09-23 |