| NPI | 1417168667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 37967) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 102115) |
| 207L00000X Anesthesiology (Licence: SC 85529) | |
| Enumeration Date | 2007-05-26 |
| Last Update Date | 2025-01-09 |