| NPI | 1922341437 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 135972) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 282592) | 
| 207L00000X Anesthesiology (Licence: IN 01090934A) | |
| 207L00000X Anesthesiology (Licence: MN 78166) | |
| Enumeration Date | 2013-04-03 | 
| Last Update Date | 2025-06-27 |