| NPI | 1245977321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 24078) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 13502799-1205) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2026-08-21 |