| NPI | 1104404136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 102903-875) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV DO3927) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-09-10 |