| NPI | 1124046628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 108437) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: MO 108437) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-12-03 |