| NPI | 1013945906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 19004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9601725) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-11-21 |