| NPI | 1053999425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO3920) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS21443) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-07-08 |