| NPI | 1497914931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101254614) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-235759) |
| 207L00000X Anesthesiology (Licence: CA A116786) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2026-03-17 |