| NPI | 1528018496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 77353) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 342616-1205) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-06-16 |