| NPI | 1194393025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 66641) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC MMD.86313) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2025-08-25 |