| NPI | 1427012400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102209653) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101011605) |
| 207L00000X Anesthesiology (Licence: WI 13123-321) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2026-02-24 |