| NPI | 1306423595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102207771) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV DO4018) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-12-16 |