| NPI | 1316569015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 111908) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1018984) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2026-08-07 |