| NPI | 1104125707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 102141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 50912) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2025-04-30 |