| NPI | 1154646891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 56976) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI L1786074) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2025-10-08 |