| NPI | 1154940427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 344862) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2024-00763) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2025-09-08 |