| NPI | 1134176050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA SP-0280) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY FL018) |
| 207L00000X Anesthesiology (Licence: CA F531) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-03-31 |