| NPI | 1538286810 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME89604) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 73562) | 
| Enumeration Date | 2007-03-23 | 
| Last Update Date | 2025-07-31 |