| NPI | 1023058146 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS006352E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA OS006352E) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2025-01-30 |