| NPI | 1871566844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 20324) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L6890) |
| 207L00000X Anesthesiology (Licence: OR MD227830) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2026-04-30 |