| NPI | 1437543527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2025050718) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 68631) |
| 207L00000X Anesthesiology (Licence: NE 32595) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2025-12-01 |