| NPI | 1891787453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 30722) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 107732) |
| 207L00000X Anesthesiology (Licence: WA MD60010628) | |
| 207L00000X Anesthesiology (Licence: OR MD207667) | |
| 207L00000X Anesthesiology (Licence: IN 01089504A) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2025-07-22 |