| NPI | 1164539110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 200911) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 059166) |
| 207L00000X Anesthesiology (Licence: CA C179089) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2026-07-17 |