| NPI | 1275107377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V1011) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 9524) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2026-06-22 |