| NPI | 1215504329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC LL86253) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101285337) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2025-04-20 |