| NPI | 1346702370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301511750) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD30105) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2026-06-29 |