| NPI | 1093984296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102204527) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL UO3656) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2025-05-09 |