| NPI | 1295796282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 28925) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD13224) |
| 207L00000X Anesthesiology (Licence: VA 0101232629) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2026-07-22 |