| NPI | 1306424742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 27737) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 12984945-1205) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-07-16 |