| NPI | 1083607998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 3369) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA DO-03369) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2025-08-19 |