| NPI | 1407424591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2025018403) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 9033) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-06-09 |