| NPI | 1245546761 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101250159)  | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101250159)  | 
| Enumeration Date | 2010-08-21 | 
| Last Update Date | 2025-04-16 |