| NPI | 1902192644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101252298) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0101252298) |
| 207L00000X Anesthesiology (Licence: NC 2022-00903) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2026-05-18 |