| NPI | 1164459194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD17687) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD17687) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2025-09-11 |