| NPI | 1265571954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101290031) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY 7044A) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2026-07-23 |