| NPI | 1437710365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301509324) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY c4684) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2025-10-28 |