| NPI | 1215564992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 95551) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0099547) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-10-08 |