| NPI | 1023008489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 99902) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 350725) |
| 207L00000X Anesthesiology (Licence: GA 100393) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2026-03-24 |