| NPI | 1851724801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V8177) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 292708) |
| 207L00000X Anesthesiology (Licence: FL ME130873) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2025-07-08 |