| NPI | 1144615584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101260767) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0108032) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-09-04 |