| NPI | 1386218485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2025-01251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL83550) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2025-06-30 |