| NPI | 1871976860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX V4987) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-55591) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-11-13 |