| NPI | 1215263025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME109217) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101251914) |
| 207L00000X Anesthesiology (Licence: MI 4301090232) | |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2025-09-08 |