| NPI | 1477027845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD222258) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 76306-20) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2025-08-01 |