| NPI | 1245428838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME111548) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR 00025965) |
| 207L00000X Anesthesiology (Licence: VA 0101284092) | |
| 207L00000X Anesthesiology (Licence: SC 93573) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2025-04-11 |