| NPI | 1356753727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 55753) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 2031-320) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2025-12-23 |