| NPI | 1023570389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 164161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101285345) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2025-05-22 |