| NPI | 1154619211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 83676) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 62440) |
| 207L00000X Anesthesiology (Licence: IL 125065442) | |
| 208600000X Surgery (Licence: WA ML60370908) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2025-01-16 |