| NPI | 1134757164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS20593) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2024-01888) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-02-24 |