| NPI | 1255891925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101284049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0097112) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2026-04-20 |