| NPI | 1376602409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 3135-320) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0019285) |
| 207L00000X Anesthesiology (Licence: TX G1370) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2026-03-11 |