| NPI | 1427626662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE TEP9275) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-12220) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2025-01-23 |