| NPI | 1972540169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164876) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 57796) |
| 207L00000X Anesthesiology (Licence: IN 01061232A) | |
| 207L00000X Anesthesiology (Licence: MD D0063964) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2026-08-31 |