| NPI | 1902849904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-55185) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 41072) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2025-09-18 |