| NPI | 1497376800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS20536) |
| Additional Taxonomies | 207LP4000X Anesthesiology, Physician Nutrition Specialist (Licence: FL OS20536) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2026-01-13 |