| NPI | 1124078605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101277618) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9500492) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-10-22 |