| NPI | 1073578902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 4794) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101011115) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2025-05-28 |