| NPI | 1003313081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 341576) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 011764) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2026-08-20 |