| NPI | 1427360189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL MS0104491) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D77197) | 
| 207L00000X Anesthesiology (Licence: AZ R72618) | |
| Enumeration Date | 2010-07-10 | 
| Last Update Date | 2024-08-16 |