| NPI | 1306882287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2026034533) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME53133) |
| 207L00000X Anesthesiology (Licence: GA 27694) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2026-08-26 |