| NPI | 1053849521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME17706) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 187967) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2025-10-31 |