| NPI | 1205880986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101270577) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL25048) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-12-17 |