| NPI | 1487091336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WY 19708A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 54319) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2026-04-17 |