| NPI | 1902195985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U8507) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD22850) |
| 207L00000X Anesthesiology (Licence: PA MD453405) | |
| 207L00000X Anesthesiology (Licence: NY 276042) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2024-09-06 |