| NPI | 1336716661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 288959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS23611) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-05-21 |