| NPI | 1841462157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2025003163) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD037169) | 
| Enumeration Date | 2008-03-26 | 
| Last Update Date | 2025-08-26 |