| NPI | 1386809440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 102612-875) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A12359) | 
| 207L00000X Anesthesiology (Licence: CT 047459) | |
| 207L00000X Anesthesiology (Licence: NV DO3686) | |
| 207L00000X Anesthesiology (Licence: WA op60020990) | |
| Enumeration Date | 2008-07-28 | 
| Last Update Date | 2025-07-08 |