| NPI | 1497908040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301086201) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY C4687) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2025-10-27 |