| NPI | 1528048865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS19838) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 43620) |
| 207L00000X Anesthesiology (Licence: NV DO3489) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2026-01-12 |