| NPI | 1174228449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: UT 14238961-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 100470) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2025-09-03 |