| NPI | 1497936124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2006-01165) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 111292) |
| Enumeration Date | 2007-11-22 |
| Last Update Date | 2026-07-31 |