| NPI | 1033670096 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 75287-20) | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WI 75287-20) | 
| Enumeration Date | 2019-03-30 | 
| Last Update Date | 2025-07-07 |